Provider Demographics
NPI:1477006633
Name:RIFI, MICHELLE (BCBA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:RIFI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 OCEAN AVE
Mailing Address - Street 2:305
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-2629
Mailing Address - Country:US
Mailing Address - Phone:310-619-4512
Mailing Address - Fax:
Practice Address - Street 1:364 OCEAN AVE
Practice Address - Street 2:305
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-2629
Practice Address - Country:US
Practice Address - Phone:310-619-4512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst